The Effect of Fogging with Hypochlorous Solution on The Rate of Healthcare-Associated Infections

Öz

Background: The prevention of healthcare-associated infections hinges on the meticulous cleaning and disinfection of patient care areas, forming the cornerstone of standard precautions. Hypochlorous solution, in contrast to other disinfectants, is a unique and effective agent due to its sterile, safe, and highly efficacious nature. This is attributed to its synthesis through the electrolysis of pure water and sodium hypochloride. In this study, we sought to assess the effectiveness of fogging hypochlorous solution in curbing the ongoing Acinetobacter outbreak in our hospital. Materials and Methods: The application of a hypochlorous solution by fogging was conducted in one intensive care unit with 10 beds, while this method was not employed in the other intensive care unit with 9 beds. Fogging was conducted on all surfaces five times a day for one month while patients were undergoing treatment in their beds. In addition to fogging, routine cleaning, disinfection and hand hygiene practices were maintained. Culture results and HAI rates for both intensive care units were recorded for the one-month period preceding fogging and the one-month period during which fogging was performed. Results: The prevalence of growths among patients decreased from 36.4% to 29% in the non-fogging ICU, while a similar decline was observed in the fogging ICU, from 54.5% to 28.1%. While the culture positivity rate in the ICU without fogging increased from 15 to 19 in the second period, this number decreased from 17 to 13 in the ICU with fogging. While the rate of healthcare-associated infection (HAI) increased from 4.5 to 12.9 in the non-fogging ICU, the rate of HAI decreased from 18.2 to 3.1 in the fogging ICU. Conclusions: It was therefore concluded that fogging with hypochlorous solution may be associated with a decrease in culture positivity and SHIE rate, and that it does not cause any adverse effects on patients, healthcare personnel or medical instruments. However, in order to reach a definitive conc-lusion on the subject, it was evaluated that our results need to be supported by prospectively desig-ned studies in which the before and after periods are standardised.

Anahtar Kelimeler

• hypochlorous acid
• fogging
• disinfectant
• cross contamination
• healthcare associated infection rate

Hipokloröz Çözelti ile Sislemenin Sağlık Hizmeti İlişkili Enfeksiyon Hızı Üzerine Etkisi

Öz

Amaç: Sağlık Hizmeti İlişkili Enfeksiyonları önlemek için, hasta bakım alanlarının temizlenmesi ve dezenfekte edilmesi standart önlemlerin en önemli parçasıdır. Kullanılan tüm dezenfektanların aksine, hipokloröz çözelti, sodium hipoklorür ile saf suyun elektrolizi ile oluşturulduğu için güvenilir, etkin ve sterilizandır. Bu çalışmamızda hastanemizde devam eden Acinetobacter salgınının engellenmesinde hipokloröz çözeltinin sisleme ile uygulanmasının etkinliğini ölçmeyi amaçladık. Materyal ve metod: Hipokloröz çözelti ile sisleme 10 yataklı bir yoğun bakım ünitesinde uygulanırken, 9 yataklı diğer yoğun bakım ünitesinde uygulanamadı. Sisleme bir ay boyunca, günde 5 kez, hastalar yataklarında tedavi almakta iken, tüm yüzeylere uygulandı. Sislemeye ek olarak rutin temizlik-dezenfeksiyon ve el hijyeni uygulamalarına devam edildi. Her iki yoğun bakım ünitesinin sisleme önce-si bir aylık dönemde ve sisleme süresince bir aylık dönemde olan kültür sonuçları ve SHİE hızları kay-dedildi. Bulgular: Sisleme uygulanmayan YBÜ’de üreme saptanan hasta sayısı %36,4’ten, %29’a düşerken, sisle-me uygulanan YBÜ’de %54,5’ten %28,1’e gerilemiştir. Sisleme yapılmayan YBÜ’de 15 kültür pozitifliği, ikinci dönemde 19’a yükselirken; sisleme uygulanan YBÜ’de bu sayı 17’den 13’e gerilemiştir. Sisleme uygulanmayan YBÜ’de SHİE hızı 4,5’tan 12,9’a çıkarken, sisleme uygulanan YBÜ’de SHİE hızı 18,2’den 3,1’e gerilemiştir. Sonuç: Hipokloröz çözelti ile sislemenin, kültür pozitifliğinde ve SHİE hızında azalma ile ilişkili olabile-ceği, hastalar, sağlık personeli ve tıbbi aletler açısından herhangi bir olumsuz duruma yol açmadığı sonucuna varılmıştır. Lakin konu hakkında kesin kanaate varmak için öncesi ve sonrası dönemin stan-dardize edilmiş olduğu prospektif dizayn edilmiş çalışmalarla sonuçlarımızın desteklenmesine ihtiyaç olduğu değerlendirilmiştir. Anahtar Kelimeler: Hipokloröz Asit, Sisleme, Dezenfektan, Çapraz Kontaminasyon, Sağlık Hizmeti İlişkili Enfeksiyon Hızı

Anahtar Kelimeler

• hipokloröz asit
• sisleme
• dezenfektan
• çapraz kontaminasyon
• sağlık hizmeti ilişkili enfeksiyon hızı

Etik Beyan

Makalemiz Şehit Prof. Dr. İlhan Varank Eğitim ve Araştırma Hastanesi Etik Kurulu’ndan 14.12.2022 tarih ve 2022/160 sayı numarası ile onaylanmıştır

Teşekkür

Çalışma süresince desteğini eksik etmeyen Yoğun Bakım Uzmanımız Uzm. Dr. İnşa Gül EKİZ İŞCANLI ve Enfeksiyon Kontrol Komitesi Hemşiremiz Elvan KUTKAN'a teşekkürü borç bilirim.

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